Dear Dr. Garner,
I get headaches frequently, and it’s usually related to very tense situations around the house. I have three children, a home-based business and 18 people coming for Thanksgiving. You can imagine the tension and the headache that comes with it.
Do you see any relief for me?
Tension Headaches in Hollis
Dear Tension Headaches,
Tension headaches are actually very common. The treatment is common sense, combining a balance of healthy habits, non-drug treatments and occasional prescription medication.
The way that people describe a tension headache includes dull or aching head pain, tenderness on either the neck or scalp and pressure across the forehead, sides and back of the head. There are two types of tension headaches described.
One known as chronic lasts hours and may actually last for several days. If you have headaches which occur on and off for three months or more, it is considered chronic. If it occurs fewer than 15 days a month for at least three months, then they are called episodic tension headaches.
It is difficult to distinguish a migraine headache from a tension headache. This is important because the treatment is different. One way to distinguish them is the fact that vision problems, nausea and vomiting are not noted with tension headaches. These are more often noted in migraines.
It sounds as if your tension headache is disrupting your life. This is a reason to visit your doctor. Some headaches are extremely dangerous and must be seen by a doctor right away. These include severe headaches, headaches with a stiff neck, difficulty speaking or mental confusion and headaches after head injuries.
Headaches that last a long time or are more frequent or severe will often be evaluated with either a CT scan or an MRI. These studies of the brain can help to evaluate abnormal blood vessels, tumors or other causes for severe headaches.
People who have tension headaches are more sensitive to pain than others. The things that cause the headache to occur include stress, which is the most common trigger for tension headaches.
Being a woman and middle-aged also increases one’s chance of having a tension headache. One study found that almost 90 percent of women and about 70 percent of men experience tension headaches during their lifetime. One of the most common causes for sick days includes tension headaches. The severe pain can incapacitate a worker. It is important to keep a diary to help you understand what’s causing your headaches, what situations may have triggered them and what kind of medications you have been taking.
Both prescription and over-the-counter pain relievers can often bring about rapid improvement. For people who are experiencing both migraine and tension headaches, there are medications known as triptans, which can effectively treat both headaches.
Often preventive medicines are given to patients with severe tension headaches. Some anti-depressants and muscle relaxants can help prevent chronic tension headaches.
You can do the following at home to help manage the headaches.
1. Lower your stress levels.
2. Apply heat or ice, whichever feels better to the neck muscles. This may ease the tension headache and bring you relief without medication.
3. Practice good posture to keep your muscles from tensing.
4. Holistic or non-traditional therapies, such as acupuncture, massage and deep breathing exercises, may be beneficial.
5. A counselor or therapist can help.
6. Regular exercise is an effective method to relax tension in the muscles.
About 80 percent of the adult population gets occasional tension headaches. Three percent suffer from chronic daily tension headaches. Causes include inadequate rest, poor posture, anxiety, hunger and overexertion. In some, the cause is never found.
The good news is that tension headaches often respond to treatment and rarely cause permanent damage.
Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.